The relative efficacy and safety of targeted agents used in combination with chemotherapy in treating patients with untreated advanced gastric cancer: a network meta-analysis

Xie, Songqiang; Zhang, Huixiang; Wang, Xueyan; Ge, Quan-Xing; Hu, Junhong

doi:10.18632/oncotarget.15923

Cited by 19 publications

(23 citation statements)

References 39 publications

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“…A previous network meta-analysis did not include apatinib, rilotumumab, regorafenib, etc. [10]. This study showed Ramucirumab to increase PFS, and endostar had superior results in 2-3 year PFS results.…”

Section: Discussionmentioning

confidence: 61%

“…Thus, targeted therapy was shown to be effective and safe for AGC. For agent selection, a recent network meta-analysis showed that ramucirumab and trastuzumab have significant advantages for improving OS and ramucirumab and endostar have significant advantages for improving PFS in AGC patients [10]. However, this study included randomized controlled trials (RCTs) which lack a blinded design so they could not eliminate psychological effects.…”

mentioning

confidence: 99%

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The efficacy and safety of targeted therapy with or without chemotherapy in advanced gastric cancer treatment: a network meta-analysis of well-designed randomized controlled trials

Zhao

et al. 2018

Gastric Cancer

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Section: Discussionmentioning

confidence: 61%

mentioning

confidence: 99%

The efficacy and safety of targeted therapy with or without chemotherapy in advanced gastric cancer treatment: a network meta-analysis of well-designed randomized controlled trials

Zhao

et al. 2018

Gastric Cancer

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“…Gastric cancer (GC) is considered the third-leading cause of death among all cancer types and has caused 723,000 deaths across the whole world. 1 , 2 Currently, the incidence of GC has been significantly increasing, with ~952,000 new cases each year. 2 The People’s Republic of China is a high-risk area for GC, and the new cases of GC in this region account for ~42.5% of such cases in the world.…”

Section: Introductionmentioning

confidence: 99%

“… 1 , 2 Currently, the incidence of GC has been significantly increasing, with ~952,000 new cases each year. 2 The People’s Republic of China is a high-risk area for GC, and the new cases of GC in this region account for ~42.5% of such cases in the world. 3 Early GC can easily be misdiagnosed because of the small number of symptoms.…”

Section: Introductionmentioning

confidence: 99%

“…The agents used in targeted therapy can precisely identify and attack certain type of cancer cells based on mutations of genes and proteins. 2 Moreover, little damage is done to normal cells; thus, molecular targeted therapy is also called a “biological missile.” The clinical application of molecular targeted therapy for malignancies has been reported, and several studies have found that the combination of molecular targeted therapy and CT has better therapeutic effects than treatment with CT alone. 8 – 13 …”

Section: Introductionmentioning

confidence: 99%

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Efficacy and safety of apatinib combined with chemotherapy for the treatment of advanced gastric cancer in the Chinese population: a systematic review and meta-analysis

Cheng¹,

Sun²,

Guo³

et al. 2018

DDDT

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ObjectiveTo systematically evaluate the efficacy and safety of the combination of apatinib targeted therapy and chemotherapy (CT) in the treatment of patients with advanced gastric cancer (GC).Materials and methodsClinical trials were extracted from PubMed, the Cochrane Library, Web of Science, EMBASE, CNKI, and the Wanfang database. Outcome measures, including therapeutic efficacy, quality of life (QOL), and adverse events, were extracted and evaluated.ResultsNineteen trials, including 1,256 advanced GC patients, were included. The results indicated that, compared with CT alone, the combination of apatinib targeted therapy with CT significantly improved the patients’ complete response rate (OR=1.85, 95% CI=1.04–3.28, P=0.04), partial response rate (OR=2.19, 95% CI=1.71–2.80, P<0.00001), overall response (OR=2.57, 95% CI=1.99–3.32, P<0.00001), and disease control rate (OR=3.46, 95% CI=2.57–4.66, P<0.00001). Moreover, the combined therapy exhibited advantages over CT alone in the patients’ QOL including the QOL improved rate (OR=1.77, 95% CI=0.94–3.33, P=0.08) and the Karnofsky performance score (OR=1.77, 95% CI=0.94–3.33, P=0.08). The group that received the combined therapy had higher rates of hypertension (OR=5.75, 95% CI=2.22–14.92, P=0.0003), albuminuria (OR=15.42, 95% CI=5.39–44.10, P<0.00001), and hand–foot syndrome (OR=2.09, 95% CI=1.26–3.48, P=0.004), whereas analyses of other adverse events, such as leucopenia, thrombocytopenia, and neutropenia, did not reveal significant differences (P>0.05).ConclusionThe combination of apatinib targeted therapy and CT is more effective for GC treatment than CT alone. However, this combined treatment could lead to greater rates of hypertension, albuminuria, and hand–foot syndrome. Therefore, the benefits and risks should be considered before treatment.

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Comparative efficacy and tolerability of targeted and immunotherapy combined with chemotherapy as first-line treatment for advanced gastric cancer: a Bayesian network meta-analysis

Liu

Wong

Xie

et al. 2022

Sci Rep

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The use of target agents and immune checkpoint inhibitors have changed the treatment landscape for AGC in the first-line setting. However, the crosswise comparison between each regimen is rare. Therefore, we estimated the efficacy and safety of targeted therapy or immunotherapy with chemotherapy in AGC patients as the first-line treatment. Included studies were divided into “average” or “specific positivity” group according to whether the patients were selected by a certain pathological expression. We conducted a Bayesian network meta-analysis for all regimens in both groups. In average group, no regimen showed significant improvements in overall survival (OS) and progression free survival (PFS), while pembrolizumab and nivolumab combined with chemotherapy were ranked first and second respectively without an obvious safety difference. In specific positivity group, zolbetuximab plus chemotherapy significantly prolonged OS (HR 0.53, 95% CI 0.36–0.79) and PFS (HR 0.45, 95% CI 0.25–0.81). The top three regimens were zolbetuximab-chemotherapy, trastuzumab plus pertuzuma-chemotherapy and nivolumab-chemotherapy respectively, with no significant safety risk. For average patients, immune checkpoint inhibitor PD-1 plus chemotherapy will be the promising regimen. For patients with overexpression of CLDN18.2, zolbetuximab combined with chemotherapy comes with greater survival benefits, while for patients who have PD-L1 expression with no HER-2 or CLDN18.2 positivity, additional immune checkpoint inhibitor of PD-1 will be a good considered option.

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The relative efficacy and safety of targeted agents used in combination with chemotherapy in treating patients with untreated advanced gastric cancer: a network meta-analysis

Cited by 19 publications

References 39 publications

The efficacy and safety of targeted therapy with or without chemotherapy in advanced gastric cancer treatment: a network meta-analysis of well-designed randomized controlled trials

The efficacy and safety of targeted therapy with or without chemotherapy in advanced gastric cancer treatment: a network meta-analysis of well-designed randomized controlled trials

Efficacy and safety of apatinib combined with chemotherapy for the treatment of advanced gastric cancer in the Chinese population: a systematic review and meta-analysis

Comparative efficacy and tolerability of targeted and immunotherapy combined with chemotherapy as first-line treatment for advanced gastric cancer: a Bayesian network meta-analysis

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